Healthcare Provider Details

I. General information

NPI: 1033329800
Provider Name (Legal Business Name): ANN LAURIA LAURIA M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 INTERFACE DR STE 400
ANN ARBOR MI
48103-9176
US

IV. Provider business mailing address

5840 INTERFACE DR STE 400
ANN ARBOR MI
48103-9176
US

V. Phone/Fax

Practice location:
  • Phone: 734-627-8001
  • Fax:
Mailing address:
  • Phone: 734-627-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: